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What's the best practice with W3 Total Cache in terms of clearing the cache... should you clear the cache each time you add a new image or article to your site?

The cache auto-clears every few hours or so automatically, so you only need to force it if whatever update you made isn't reflected on the next visit by a logged out user (use a different browser to hit the site and see). When you update a post or page, W3 will purge that object from the cache and regenerate it so you just sort of learn to work the cache as you need to. What you don't want to do is constantly purge the caches as that will defeat the purpose of having a cache to begin with.

Your scores are low mainly due to the number of requests being made and the relatively large images you're loading. There's not a lot you can do about that other than to:

1) Cut down on what it loading on the front page
2) Be more aggressive about optimizing images
3) Invest time/effort in writing a better lazy loading script so the page will render a bit faster and/or:
4) Try a CDN, especially one that can defer javascript loading. As Lucas recommends, CloudFlare can kinda/sorta do it but you may want to look at MaxCDN or another company to get it a little better. Installing mod_pagespeed may also help:

One thing your reports don't really measure is how quickly the web server begins serving data in response to the initial GET request. If your server is underpowered or if the internal routing is poor, the time to first byte (TTFB) may be a heartbeat or two slower than it should be. Meanwhile, the user is staring at a white screen and you may lose them. Once the loading animation shows up, you have to address the other issues the report mentions (too many requests, unoptimized images, etc).

But people are much more likely to bounce from a blank screen than a loading icon...

oo7mlAuthor Commented: 2015-04-02

Ok great. This is one of my worries. My hosting company is saying that their server is running fine, but I have no way to prove this?

Is there anyway to generate a report or any evidence of how the server itself is responding / performing?

Those results are not encouraging at all. If Google can't even complete the tests most of the time (tried over several attempts), your server is not returning enough data fast enough. Whether that is due to poor server/network architecture or your scripts, it's hard to say.

I should also mention that in regards to the tests you posted, the testing server is located in Vancouver, Canada. Meanwhile, your site (78.137.164.84) is on a server in Dublin and the site you're comparing yourself with (104.28.28.117) is using Cloudflare.

Hence, it makes sense why a site using a CDN performs better than a site located in Dublin, when the testing server is on the other side of the globe. This is a scenario where a CDN really shows its benefits.

However, if you were to perform this same test from a location closer to your host, you may see that the CDN wouldn't provide as much performance benefit.